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NPI Code Detail

MEDICARE: RANDY HELWIG R.D.

MEDICARE: RANDY HELWIG R.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282NR1301XRural Acute Care Hospital955336CA

General Provider Information

NPI Number : 1942690300
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY HELWIG R.D.
Provider Business Mailing Address
First Line : 8129 PONDEROSA WAY
Second Line :
City : MOUNTAIN RANCH
State : CA
Zip : 95246-9469
Country : US
Telephone Number : 209-754-2666
Fax Number :
Provider Business Practice Location Address
First Line : 768 MOUNTAIN RANCH RD
Second Line :
City : SAN ANDREAS
State : CA
Zip : 95249-9707
Country : US
Telephone Number : 209-754-2666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2015
Last Update Date : 01/23/2015

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